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                                                                                                                                                                                    OMB No. 1210-0110 
      SCHEDULE SB                                           Single-Employer Defined Benefit Plan 
                                                                                                                                                                                           
           (Form 5500)                                                           Actuarial Information 
          Department of the Treasury                                                                                                                                                     2022 
          Internal Revenue Service                       This schedule is required to be filed under section 104 of the Employee                                                           
           Department of Labor                           Retirement Income Security Act of 1974 (ERISA) and section 6059 of the                                                This Form is Open to Public 
   Employee Benefits Security Administration 
                                                                                 Internal Revenue Code (the Code). 
    Pension Benefit Guaranty Corporation                                                                                                                                                 Inspection  File as an attachment to Form 5500 or 5500-SF. 
 For calendar plan year 2022 or fiscal plan year beginning                                                                            and ending                                                       
 Round off amounts to nearest dollar.Caution: A penalty of $1,000 will be assessed for late filing of this report unless reasonable cause is established. 
A  Name of plan                                                                                                                        B  Three-digit 
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI                                                                                         plan number (PN)                                             001 
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI 
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI                                                                                                 
C  Plan sponsor’s name as shown on line 2a of Form 5500 or 5500-SF                                                                     D    Employer Identification Number (EIN) 
   ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDEFGHI                                                                                      012345678 
                      ABCDEFGHI ABCDEFGHI  
E  Type of plan:     XSingle       XMultiple-A      XMultiple-B                           F Prior year plan size:    X100 or fewer      X101-500     XMore than 500 
  Part I         Basic Information  
 1  Enter the valuation date:                     Month _________    Day _________    Year _________                                                                                                             
 2  Assets:                                                                                                                                                                    
   a Market value ....................................................................................................................................................   2a         -123456789012345 
   b Actuarial value .................................................................................................................................................   2b         -123456789012345 
                                                                                                                                       (1) Number of  (2) Vested Funding                  (3) Total Funding 
 3  Funding target/participant count breakdown                                                                                         participants                          Target             Target 
    a For retired participants and beneficiaries receiving payment ....................................                                                                                                          
    b For terminated vested participants...........................................................................                                                                                              
    c For active participants .............................................................................................                                                                                      
    d Total ........................................................................................................................                                                                             
 4  If the plan is in at-risk status, check the box and complete lines (a) and (b)............................. X                                                               
    a Funding target disregarding prescribed at-risk assumptions ..............................................................................                            4a       -123456789012345 
    b Funding target reflecting at-risk assumptions, but disregarding transition rule for plans that have been in 
      at-risk status for fewer than five consecutive years and disregarding loading factor ...........................................                                     4b 
                                                                                                                                                                                    -123456789012345 
 5  Effective interest rate ............................................................................................................................................   5                    123.12% 
 6  Target normal cost ................................................................................................................................................    
    a Present value of current plan year accruals .......................................................................................................                  6a                                    
    b Expected plan-related expenses .......................................................................................................................               6b                                    
    c Total (line 6a + line 6b)  .....................................................................................................................................     6c                                    
Statement by Enrolled Actuary 
   To the best of my knowledge, the information supplied in this schedule andSAMPLEaccompanying schedules, statements and attachments, if any, is complete and accurate. Each prescribed assumption was applied in 
   accordance with applicable law and regulations. In my opinion, each other assumption is reasonable (taking into account the experience of the plan and reasonable expectations) and such other assumptions, in 
   combination, offer my best estimate of anticipated experience under the plan. 

   SIGN                                                                                                                                    
  HERE 
                                                Signature of actuary                                                                                                                Date 
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDE                                                                                                                                                        YYYY-MM-DD 
                                     Type or print name of actuary                                                                                                      Most recent enrollment number 
ABCDEFGHI ABCDEFGHI ABCDEFGHI ABCDE                                                                                                                                                             1234567 
                                                Firm name                                                                                            Telephone number (including area code) 
 123456789 ABCDEFGHI ABCDEFGHI ABCDE                                                                                                                                                       1234567890 
 123456789 ABCDEFGHI ABCDEFGHI ABCDE 
 UK                                                                                                                                     
                                                Address of the firm                                                                                                                   
If the actuary has not fully reflected any regulation or ruling promulgated under the statute in completing this schedule, check the box and see instructions                                           X   
For Paperwork Reduction Act Notice, see the Instructions for Form 5500 or 5500-SF.                                                                                             Schedule SB (Form 5500) 2022 
                                                                                                                                                                                                      v. 220413 



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              Schedule SB (Form 5500) 2022                                                    Page 2 -                                               1- x  
                   
  Part II           Beginning of Year Carryover and Prefunding Balances 
                                                                                                                                             (a) Carryover balance         (b)  Prefunding balance 
  7 Balance at beginning of prior year after applicable adjustments (line 13 from prior                                                                                    -123456789012345 
    year) ...........................................................................................................................        -123456789012345

  8 Portion elected for use to offset prior year’s funding requirement (line 35 from prior 
    year)  ..........................................................................................................................        -123456789012345              -123456789012345 
  9  Amount remaining (line 7 minus line 8) .......................................................................                          -123456789012345              -123456789012345 
 10 Interest on line 9 using prior year’s actual return of                   % ................................                              -123456789012345              -123456789012345 
 11 Prior year’s excess contributions to be added to prefunding balance:                                                                                                   
    a Present value of excess contributions (line 38a from prior year) ..............................                                                                      -123456789012345 
    b(1) Interest on the excess, if any, of line 38a over line 38b from prior year    
              Schedule SB, using prior year's effective interest rate of                   % .............  
                                                                                                                                                                           -123456789012345 
    b(2) Interest on line 38b from prior year Schedule SB, using prior year's actual      
                   return ................................................................................................................                                                                                      
        c Total available at beginning of current plan year to add to prefunding balance ...............                                                                                                                        
      
    dPortion of (c) to be added to prefunding balance .....................................................                                                                -123456789012345 
 12 Other reductions in balances due to elections or deemed elections ............................                                           -123456789012345
                                                                                                                                                                           -123456789012345 123456789012345 
 13 Balance at beginning of current year (line 9 + line 10 + line 11d – line 12) ..................                                          -123456789012345              -123456789012345 
   Part III          Funding Percentages 
 14 Funding target attainment percentage ....................................................................................................................................................................   14   123.12% 
 15 Adjusted funding target attainment percentage .....................................................................................................................................   15                         123.12% 
 16 Prior year’s funding percentage for purposes of determining whether carryover/prefunding balances may be used to reduce current 
                                                                                                                                                                                                               16 
    year’s funding requirement ....................................................................................................................................................................                  123.12% 
 17 If the current value of the assets of the plan is less than 70 percent of the funding target, enter such percentage. ................................   17                                                       123.12% 
   Part IV           Contributions and Liquidity Shortfalls 
 18 Contributions made to the plan for the plan year by employer(s) and employees: 
       (a) Date                 (b) Amount paid by        (c) Amount paid by              (a) Date                                                    (b) Amount paid by   (c) Amount paid by 
   (MM-DD-YYYY)                     employer(s)                 employees             (MM-DD-YYYY)                                                          employer(s)                                         employees 
                                                                                                                                                                                                                                
  YYYY-MM-DD                 12345678901234             12345678901234                YYYY-MM-DD                                                     12345678901234        123456789012345-
                                                                                                                                                                                                                                
  YYYY-MM-DD                 12345678901234             12345678901234                YYYY-MM-DD                                                     12345678901234        123456789012345- 
                                                                                                                                                                                                                                
  YYYY-MM-DD                 12345678901234             12345678901234                YYYY-MM-DD                                                     12345678901234        123456789012345-  
                                                                                                                                                                                                                                
  YYYY-MM-DD                 12345678901234             12345678901234                YYYY-MM-DD                                                     12345678901234        123456789012345-   
                                                                                                                                                                                                                                
  YYYY-MM-DD                 12345678901234             12345678901234                                                                                                                                                          
                                                                                                                                                                                                                                  
                                                                                     Totals                                                   18(b)                      18(c)                                                    
                                                          SAMPLE 
 19 Discounted employer contributions    – see instructions for small plan with a valuation date after the beginning of the year:                                                                                                 
                                                                                                                                                                          
    a Contributions allocated toward unpaid minimum required contributions from prior years. .....................................  19a                                    -123456789012345  
                                                                                                                                                                          
    b Contributions made to avoid restrictions adjusted to valuation date. ....................................................................  19b                       -123456789012345 
                                                                                                                                                                          
    c Contributions allocated toward minimum required contribution for current year adjusted to valuation date. ...................   19c                                  -123456789012345 
 20 Quarterly contributions and liquidity shortfalls:                                                                                                                                                               
                                                                                                                                                                          
    a     Did the plan have a “funding shortfall” for the prior year? ..........................................................................................................................                X    Yes   X No 
                                                                                                                                                                          
    b     If line 20a is “Yes,” were required quarterly installments for the current year made in a timely manner?....................................................                                          X    Yes   X No 
                                                                                                                                                                          
    c If line 20a is “Yes,” see instructions and complete the following table as applicable:                                                                                                                        
                                                                                                                                                                          
                                                        Liquidity shortfall as of end of quarter of this plan year                                                        
                                                                                                                                                                          
                   (1)   1st                              (2)  2nd                                                                           (3)  3rd                           (4)  4th 
                                                        -123456789012345                                                                     -123456789012345              -123456789012345 
                                         



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           Schedule SB (Form 5500) 2022                                                            Page 3 
                 
   Part V       Assumptions Used to Determine Funding Target and Target Normal Cost 
  21  Discount rate: 
      a  Segment rates:           1st segment:                                   2nd segment:                                 3rd segment: 
                                  123.12_%                                       123.12_%                                     123.12 %                                                X N/A, full yield curve used 

      b Applicable month (enter code) ........................................................................................................................                    21b                                           1 
  22  Weighted average retirement age .......................................................................................................................    22                                                             12 
  23  Mortality table(s)  (see instructions)     _    Prescribed - combined               _Prescribed - separate             _Substitute   
   Part VI   Miscellaneous Items 
  24  Has a change been made in the non-prescribed actuarial assumptions for the current plan year?  If “Yes,” see instructions regarding required  
      attachment. ................................................................................................................................................................................................... X Yes   X No 

  25  Has a method change been made for the current plan year?  If “Yes,” see instructions regarding required attachment. ................................X                                                             Yes   X No 
  26  Demographic and benefit information 
      a Is the plan required to provide a Schedule of Active Participants?  If “Yes,” see instructions regarding required attachment. ...............                                                                 X Yes X No 
      b Is the plan required to provide a projection of expected benefit payments? If “Yes,” see instructions regarding required attachment ...                                                                       X Yes X No 
  27  If the plan is subject to alternative funding rules, enter applicable code and see instructions regarding 
                                                                                                                                                                                  27                                                
      attachment ..........................................................................................................................................................  
   Part VII     Reconciliation of Unpaid Minimum Required Contributions For Prior Years 
  28  Unpaid minimum required contributions for all prior years ...................................................................................                               28   -123456789012345 
  29  Discounted employer contributions allocated toward unpaid minimum required contributions from prior years 
                                                                                                                                                                                  29 
      (line 19a) .............................................................................................................................................................         -123456789012345 
  30  Remaining amount of unpaid minimum required contributions (line 28 minus line 29) .........................................    30                                                -123456789012345 
   Part VIII    Minimum Required Contribution For Current Year 
  31  Target normal cost and excess assets (see instructions): 
     a Target normal cost (line 6c) .............................................................................................................................                 31a  -123456789012345 
     b Excess assets, if applicable, but not greater than line 31a  ..............................................................................                                31b                                  
  32  Amortization installments:                                                                                              Outstanding Balance                                      Installment 
      a Net shortfall amortization installment ...........................................................................    -123456789012345                                         -123456789012345 
      b Waiver amortization installment ...................................................................................   -123456789012345                                         -123456789012345 
  33  If a waiver has been approved for this plan year, enter the date of the ruling letter granting the approval                       
                                                                                                                                                                                  33 
      (Month _________    Day _________    Year _________ )_and the waived amount ..........................................                                                           -123456789012345 
  34  Total funding requirement before reflecting carryover/prefunding balances (lines 31a - 31b + 32a + 32b - 33).....  34                                                            -123456789012345 
                                                                                 Carryover balance                            Prefunding balance                                       Total balance 
  35  Balances elected for use to offset funding 
      requirement ..............................................................SAMPLE -123456789012345                       -123456789012345                                         -123456789012345 
  36  Additional cash requirement (line 34 minus line 35) ............................................................................................                            36   -123456789012345 
  37  Contributions allocated toward minimum required contribution for current year adjusted to valuation date (line 
                                                                                                                                                                                  37 
      19c) ....................................................................................................................................................................        -123456789012345 
  38  Present value of excess contributions for current year (see instructions) 
        a Total (excess, if any, of line 37 over line 36)                                                                                                                         38a                                                 
        b Portion included in line 38a attributable to use of prefunding and funding standard carryover balances ...........                                                      38b                                               
  39  Unpaid minimum required contribution for current year (excess, if any, of line 36 over line 37) ...........................   39                                                 -123456789012345 
  40  Unpaid minimum required contributions for all years ...........................................................................................    40                            -123456789012345 
  Part IX        Pension Funding Relief Under the American Rescue Plan Act of 2021 (See Instructions) 
  41  If an election was made to use the extended amortization rule for a plan year beginning on or before December 31, 2021, check the box to indicate the first 
     plan year for which the rule applies.   X2019         2020         X        2021X
  






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